| National Provider Identifier [NPI]: | 1730278318 |
| Last Name Of The Provider | CHOW |
| First Name Of The Provider | ULYSS |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1403 LOMITA BLVD |
| Street Address 2 Of The Provider | SUITE 304 |
| City Of The Provider | HARBOR CITY |
| Zip Code Of The Provider | 907102076 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 17 |
| Number Of Services | 768 |
| Number Of Medicare Beneficiaries | 92 |
| Total Submitted Charge Amount | 92937 |
| Total Medicare Allowed Amount | 48383.03 |
| Total Medicare Payment Amount | 33267.43 |
| Total Medicare Standardized Payment Amount | 31080.33 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 53 |
| Number Of Medicare Beneficiaries With Drug Services | 41 |
| Total Drug Submitted ChargeAmount | 1465 |
| Total Drug Medicare AllowedAmount | 937.1 |
| Total Drug Medicare PaymentAmount | 912.87 |
| Total Drug Medicare Standardized Payment Amount | 912.87 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 13 |
| Number Of Medical Services | 715 |
| Number Of Medicare Beneficiaries With Medical Services | 92 |
| Total Medical Submitted Charge Amount | 91472 |
| Total Medical Medicare Allowed Amount | 47445.93 |
| Total Medical Medicare Payment Amount | 32354.56 |
| Total Medical Medicare Standardized Payment Amount | 30167.46 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 37 |
| Number Of Beneficiaries Age 75 to 84 | 37 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 43 |
| Number Of Male Beneficiaries | 49 |
| Number Of Non Hispanic White Beneficiaries | 45 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 15 |
| Number Of Hispanic Beneficiaries | 19 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 70 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 22 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 18 |
| Percent Of With Chronic Kidney Disease | 20 |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 54 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 22 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 21 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.1937 |